發(fā)布時(shí)間：2018-08-13 12:38

【摘要】：目的探討醫(yī)學(xué)3D打印技術(shù)、三維重建技術(shù)在精準(zhǔn)肝切除術(shù)前評(píng)估的應(yīng)用價(jià)值。方法回顧性分析2016年1月至2016年12月在寧夏醫(yī)科大學(xué)總醫(yī)院肝膽外科6例復(fù)雜性肝臟腫瘤患者臨床資料。其中男4例,女2例,平均年齡54歲。患者術(shù)前經(jīng)64排上腹部增強(qiáng)CT掃描,獲取薄層掃描DICOM數(shù)據(jù),使用三維可視化軟件(MI-3DVS)進(jìn)行三維重建,將重建的STL格式文件數(shù)據(jù)導(dǎo)入3D打印機(jī),采用樹(shù)脂及石膏材料打印出1:1肝臟物理模型,分析肝臟解剖、術(shù)前評(píng)估并進(jìn)行術(shù)前模擬,結(jié)合三維重建數(shù)據(jù),在3D打印肝臟模型指導(dǎo)下行精準(zhǔn)肝臟切除。結(jié)果全部患者進(jìn)行了肝臟三維重建及肝臟3D打印,能清晰顯示肝內(nèi)脈管系統(tǒng)、肝臟及腫瘤組織解剖形態(tài)、腫瘤與肝內(nèi)血管結(jié)構(gòu)毗鄰關(guān)系,準(zhǔn)確計(jì)算肝臟體積、腫瘤體積等。根據(jù)三維重建及3D打印肝臟模型結(jié)果,6例患者均行精準(zhǔn)肝切除,實(shí)際手術(shù)過(guò)程與術(shù)前手術(shù)規(guī)劃完全符合(6/6),模擬切除肝臟體積與實(shí)際切除肝臟體積顯著相關(guān),無(wú)圍手術(shù)期期死亡,無(wú)嚴(yán)重手術(shù)并發(fā)癥。結(jié)論醫(yī)學(xué)3D打印技術(shù)可應(yīng)用于肝臟腫瘤的手術(shù)規(guī)劃,在精準(zhǔn)肝切除的術(shù)前評(píng)估有一定的指導(dǎo)意義。
[Abstract]:Objective to evaluate the value of 3 D printing and 3 D reconstruction in the evaluation of accurate hepatectomy. Methods from January 2016 to December 2016, the clinical data of 6 patients with complicated hepatic tumors in the Department of Hepatobiliary surgery, Ningxia Medical University General Hospital were retrospectively analyzed. There were 4 males and 2 females with an average age of 54 years. Before operation, the patients were scanned by 64 rows of enhanced upper abdomen CT to obtain thin layer scanning DICOM data, and 3D reconstruction was carried out by using 3D visualization software (MI-3DVS). The reconstructed STL format file data was imported into 3D printer. The 1:1 liver physical model was printed with resin and gypsum, and the liver anatomy was analyzed. The liver was evaluated and simulated before operation. Combined with 3D reconstruction data, the accurate liver resection was guided by 3D printed liver model. Results all the patients underwent 3D liver reconstruction and 3D printing, which could clearly display the intrahepatic vascular system, the anatomical morphology of liver and tumor tissue, the adjacent relationship between tumor and intrahepatic vascular structure, and accurately calculate the volume of liver and tumor. According to the results of 3D reconstruction and 3D printing liver model, all 6 patients underwent accurate hepatectomy. The actual operation process was in good agreement with the preoperative operation planning (6 / 6). The simulated liver volume was significantly correlated with the actual liver volume, and no perioperative death was found. There were no severe surgical complications. Conclusion Medical 3D printing technique can be used in the planning of liver tumor surgery, and it has certain guiding significance in preoperative evaluation of accurate hepatectomy.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R735.7;TP391.73

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本文編號(hào)：2181016